A scare over a mystery illness on an airliner in California turned out to be a false alarm, but the cautious reaction by officials suggested that serious concerns about the disease have made their way to America's shores.
An American Airlines flight from Tokyo that landed in San Jose, Calif., was briefly halted on the tarmac after the captain reported five people on board appeared to have symptoms of severe acute respiratory syndrome, or SARS.
None of the five turned out to have the disease, which has been blamed for about 2,200 cases and at least 78 deaths worldwide. Seventy cases of the illness are suspected in the United States, but no one has died.
The disease has been spreading rapidly in Asia, and the World Health Organization, the U.N.'s health agency, advised travelers Wednesday to avoid visiting Hong Kong and the southern Chinese province of Guangdong.
The U.S. Centers for Disease Control and Prevention had already recommended postponing nonessential trips to mainland China, Hong Kong, Singapore and Hanoi, Vietnam.
The plane that landed in San Jose stopped short of the gate Tuesday morning and ambulances lined up on the tarmac as 125 passengers and 14 crew members waited on board. The plane was isolated for more than an hour before anyone was allowed to leave.
Within hours, doctors had cleared all five people suspected of having the illness, which causes a fever, sometimes with chills, headache and body aches, and can lead to a cough and shortness of breath.
It was the first time a plane was stopped in the United States for fear of passengers spreading the disease, and some passengers and health officials suggested it may have been unnecessary.
A man sitting near three of the passengers suspected of having SARS said they showed no signs of illness.
"It's an overreaction of some sort," said Bob Beom of Grants Pass, Ore.
American Airlines spokesman Todd Burke said the company has distributed information about SARS and its symptoms to all employees.
"Our crews are trained for medical situations," he said. "They do evaluate and act accordingly."
Health officials say there's no sign that SARS is spreading freely anywhere in the country. The disease, which originated in Asia, seems to be confined mostly to international travelers, along with health care workers and others who have been in close contact with SARS patients.
They also say the SARS germ, not yet firmly identified, appears to spread mostly through coughing or sneezing. But it's possible it might also spread more broadly by airborne transmission, or by inhabiting surfaces like doorknobs, experts said.
U.S. health officials say the disease is not spreading as rapidly in the United States as it is in Asia or in Toronto, where there is a related outbreak.
Health officials said Tuesday that two more people in Canada have died because of the illness, bringing the country's death toll to six.
On Wednesday, China reported 12 more deaths and disclosed that the disease had shown up in three provinces where cases hadn't previously been reported. The country also granted the WHO permission to visit the hard-hit Guangdong region, which the agency said it would do Thursday.
The U.S. consulate in Hong Kong said nonessential U.S. government workers and family members worried about SARS can leave the consulates in Hong Kong and Guangzhou, the Guangdong provincial capital, and fly home. Susan N. Stevenson, spokeswoman at the Hong Kong consulate, said no one there has become ill with the disease.
Also in Hong Kong, some 240 residents of an apartment complex where SARS has spread were taken to quarantine camps Tuesday.
Tommy Thompson, secretary of the U.S. Department of Health and Human Services, said such measures don't yet appear warranted in the United States.
"If there is a virus that is explosive ... and the only way to control it is by quarantine, we have to consider it," he said Tuesday in Atlanta. "But we're not there yet."
Authorities around the country have taken steps short of quarantines to try to contain the illness.
U.S. health authorities are handing out warning cards to travelers who arrive by plane or ship from Asia, including those who may have passed through infected countries. The cards advise them to monitor their health for at least 10 days because of possible exposure to SARS.
"If you become ill with fever accompanied by cough or difficulty in breathing, you should consult a physician," the cards say.
SARS prompted precautionary steps Tuesday at Syracuse University, which cut short a study-abroad program in Hong Kong and called home 31 students -- 15 Syracuse students and 16 from other colleges. The university in New York state also has decided to cancel two upcoming summer programs in mainland China.
In Greenwich, Conn., the Greenwich Country Day School asked more than 40 students and staff members to stay home for a few days because they had recently visited the Far East, some on a class trip. None of them have shown symptoms of SARS, the school said Tuesday.
"This is probably the most conservative position that any school in the United States is taking," said Headmaster Doug Lyons, who decided Sunday to have the students and staff stay home. "A reasonable person might say, 'Doug you're overreacting,' and I would accept that and say, 'You may be right. Forgive me."'
Thompson, who was touring a new CDC emergency operations center, said more pressure would be applied on China. The disease first unfolded there but was kept quiet for months.
Travel agencies, meanwhile, reported cancellation of trips to Asia.
At 5 Oceans Tours in Westminster, Calif., some customers have canceled flights to the continent, and weekly bookings for trips there have dropped from 100 to five, according to manager Cam Tsai.
"It's kind of serious when people in Hong Kong are wearing masks," Tsai said. "I wouldn't go, either."